Arthrogryposis

Patient with arthrogryposis after rotation of left arm but before surgery on right arm and before wrist surgery.

One of the many challenges in the child with arthrogryposis is internal rotation of the arms (arms rotated towards body).  This can make functional activities like bringing the hands together difficult.   It can be tough to even identify the front of the elbows- especially when the elbows don’t bend.

To address this internal rotation position, the humerus can be rotated with surgery (osteotomy or cutting of the bone) which can really improve alignment.  See the attached picture.  The left arm has been corrected and is resting in a more natural posture.  The right side remains markedly internally rotated! 

Ho Chi Minh City

I am sitting in the Tokyo airport awaiting my plane to fly back to the USA.  Had a great 4 days in Vietnam with an international group of congenital hand surgeons.  I was flattered to be asked to join the meeting.  I arrived a day early so had a chance to tour Ho Chi Minh City (formerly Saigon) and surrounding areas.  Fascinating history, interesting museums .

Anyway, learned much about the Vietnam War (or the American War as it is called there) and even more about the new Vietnam.  It is still a communist country but sure doesn't feel that way.  A great deal of entrepeneur spirit.  Crazy traffic (see video)- can be a challenge to cross the straight (and this wasn't even a busy street).